In a study of 119,769 living kidney donors in the United States, Jayme E. Locke, MD, MPH, of the University of Alabama at Birmingham, and colleagues found that individuals who were obese at the time of donation had a significant 86% increased risk of ESRD compared with their non-obese counterparts in adjusted analyses, according to a paper published online ahead of print in Kidney International. The investigators adjusted for age, sex, ethnicity, blood pressure, baseline estimated glomerular filtration rate, and relationship to recipient.

In addition, each 1-unit increment in body mass index (BMI) above 27 kg/m2 was associated with a significant 7% increased risk of ESRD.

Dr Locke and colleagues commented that their study is the first national study to examine risk for ESRD among a cohort of obese living kidney donors.

The study population, identified using the Scientific Registry of Transplant Recipients, consisted of 20,588 obese donors (BMI of 30 kg/m2 or above), 58,004 non-obese donors (BMI below 30 kg/m2), and 41,177 donors whose BMI was not known. The maximum follow-up was 20 years. The estimated incidence of ESRD 20 years after donation was 93.9 per 10,000 for obese donors compared with 39.7 per 10,000 for non-obese donors, a significant difference between the groups.

“These data have important implications for donor selection, predonation management of living donor candidates, and informed consent discussions with obese persons considering living donation,” the investigators concluded.